Conditions + Treatments

Tracheomalacia in Children

Think about breathing in and out: When you inhale, your chest expands, and when you exhale, your chest wall contracts, to help push the air out. This action puts pressure on some internal parts of the body, such as the heart, the lungs and the trachea (windpipe).

A healthy trachea is supported by a series of “c-shaped” rings made of cartilage that help your airway to stay open during exhalation. Tracheomalacia means that these rings aren’t strong enough to keep the trachea open during exhalation, and the trachea can become so narrow that it’s hard to breathe.

Almost 100 percent of babies with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) have some degree of tracheomalacia.

Sometimes tracheomalacia can occur on its own, without another condition.

Tracheomalacia may be congenital (present at birth), or acquired later.

Tracheomalacia may be mild (requiring little to no treatment) moderate or severe. Severe tracheomalacia can be life-threatening.

The great majority of children with tracheomalacia will either outgrow it by the time they turn 2 or don’t have it severely enough to need surgery.

How Boston Children’s Hospital approaches tracheomalacia

The specialists in our Esophageal Atresia Treatment (EAT) Program are experts in recognizing, diagnosing and caring for children with tracheomalacia and other congenital or acquired anomalies involving the trachea and esophagus. Our EAT program is the world's only center offering the Foker Process—the most advanced and effective surgical treatment of esophageal atresia (EA), commonly associated with tracheoesophageal fistula (TEF).

The Foker Process

John Foker, MD, a pediatric surgeon from the University of Minnesota, developed a process to stimulate the upper and lower ends of the esophagus to make them grow, allowing them to then be joined together. Find out more.